Bruce Michael Carpenter, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN 9564 Issued in FL

Practice address

8000 NW 80TH Place
Raiford, FL 32083

Phone

(904) 368-1477

NPI assigned

Jun 6, 2006

Last updated

Nov 6, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1891734588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13689 MARKHAM HILL DRIVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32225",
            "telephone_number": "904-614-0377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8000 NW 80TH PLACE",
            "city": "RAIFORD",
            "state": "FL",
            "postal_code": "32083",
            "telephone_number": "904-368-1477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "BRUCE",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 9564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wilbur Bala, M.D.
• Laura Ann Cook, PMHNP-BC
• Catrina Michelle Edwards, LPN
• Florida Dept of Corrections
• Carmelita E Garcia
• Cecilia Ifeoma Ibe, ARNP

• General Practice Dentistry in Raiford, FL
• Providers in Raiford, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.